


<table width="100%" class="searchPanels"  >

		<tr>
            <td  >
                <table width="100%" class="searchPanels" style="border-width: 0;">
		          	   <tr>
		          	    <td width="15%">
								Disnea:			
			 			</td>
	                 	<td width="18%" > 					
                 		    <div id="" >
                  				  <input type="text" name="nameAgregarCardioDisnea" style="width: 100px;" value="" maxlength="30"/>
                   			</div>	
               	 		</td>
                   	    <td width="15%">
							 	Palpitaciones:		
			 			</td>
	                 	<td width="18%" > 					
                 		    <div id="" >
                  				  <input type="text" name="nameAgregarCardioPalpitaciones" style="width: 100px;" value="" maxlength="30"/>
                   			</div>	
               	 		</td>
                   	    <td width="15%">
								Dolor precordial:		
			 			</td>
	                 	<td width="18%"> 					
                 		    <div id="" >
                  				  <input type="text" name="nameAgregarCardioDolorPrecordial" style="width: 100px;" value="" maxlength="30"/>
                   			</div>	
               	 		</td>
                </tr>
          	 </table>
           </td>
       </tr> 

		<tr>
            <td >
                <table width="100%" class="searchPanels" style="border-width: 0;">
		          <tr>
		          	    <td width="15%">
								S&iacute;ncope:			
			 			</td>
	                 	<td width="18%" > 					
                 		    <div id="" >
                  				  <input type="text" name="nameAgregarCardioSincope" style="width: 100px;" value="" maxlength="30"/>
                   			</div>	
               	 		</td>
                   	    <td width="15%">
								Claudicaci&oacute;n intermitente:		
			 			</td>
	                 	<td width="18%" > 					
                 		    <div id="" >
                  				  <input type="text" name="nameAgregarCardioClaudicacion" style="width: 100px;" value="" maxlength="30"/>
                   			</div>	
               	 		</td>
                   	    <td width="15%">
								Otros:		
			 			</td>
	                 	<td width="18%" > 					
                 		    <div id="" >
                  				  <input type="text" name="nameAgregarCardioOtrosAnamnesis" style="width: 100px;" value="" maxlength="30"/>
                   			</div>	
               	 		</td>
                 </tr>
          	  </table>
           </td>
       </tr> 
       
 	   <tr>
            <td >
                <table width="100%" class="searchPanels" style="border-width: 0;">

	               	<tr>
		 	    		   <td width="75px">
                 				<b>Conclusiones:</b>
                 			</td>
              	     	   <td >
                 				<div id="">
                 					<textarea name="nameAgregarCardioConclusionesAnamnesis" cols="50" rows="4"></textarea>
                   				</div>	
                 			</td>  	 
             	    </tr>
          	 	</table>
           </td>
       </tr> 
     
     
</table>